In-hospital Mortalities in General Surgery Unit, Korle Bu Teaching Hospital

Abstract

Background: In-hospital mortality data is an invaluable resource that has been employed over the years to assess the quality of care provided to patients.Materials and Methods: A retrospective study was carried out from January 1999 to December 2012. Data was collected from theinformation sheets provided by the Department of Surgery for the monthly morbidity and mortality meetings. Information extracted included the total number of admissions and deaths, the demography of the deaths, duration of admission, diagnosis and causeof death.Results: Total admissions were 37,034 with 2033 deaths giving a mean crude mortality rate of 5.5%. Detailed analysis in this study was based on 2011 cases whose complete data was available. Males accounted for 1074 (53.4%) and females 937 (46.6%). Their mean age was 53.8 ±18.6 years. Malignancies were 890 (44.3%) whilst non-malignant conditions were 1121 (55.7%). Of the non-malignant cases 1007 (89.9%) were emergency or urgent. The most frequent malignant conditions were breast cancer 204 (22.9%), colorectal cancer 144 (16.2%), pancreatic cancer 133 (14.9%) and gastric cancer 130 (14.6%); while that for the non-malignant conditions were diabetic septic conditions 219 (19.5%), gastro-intestinal bleeding 136 (12.1%), typhoid perforation 76 (6.8%) and perforated peptic ulcer 75(6.7%). The overall median length of stay was 7 days, Interquartile Range (IQR),was 2-16 days. Nonmalignant cases stayed shorter compared with the malignant cases, 5 as against 9 days, z = -8.9, Asymp. Sig. (2-sided) of 0.0001. Septicaemia and septic shockcombined were the commonest cause of death in 719 (35.8%) cases, followed by metastatic tumour - 629 (30%).Conclusion: Death was inevitable in a large proportion of the cases admitted to the General Surgery unit of Korle-Bu Teaching Hospital largely because of the nature of the surgical pathology at presentation.